DS19 Characterizing ergonomics in dermatology surgical practice: results of an online questionnaire distributed by the British Society for Dermatological Surgery
Authors: Aine Kelly, Marc Lawrence, William Hunt
Journal: British Journal of Dermatology (2023)

Abstract Ergonomics is the study of the interaction between humans and their working environment. By evaluating workplace ergonomics, we can reduce the potential for injury and ill health and improve performance and productivity. Poor postures can contribute to surgical fatigue and introduce errors due to impaired psychomotor performance. Furthermore, it reduces physician wellbeing and career longevity. A US study in 2010 reported that &amp;gt; 90% of Mohs surgeons suffered from musculoskeletal injury at work. No study of ergonomics in dermatological surgery has been undertaken outside of the USA. We aimed to characterize the incidence of musculoskeletal injuries and ergonomic practices among dermatological surgeons in the UK and Ireland. An online questionnaire consisting of 17 questions was circulated via the British Society for Dermatological Surgery in January 2023. There were 74 responders from the UK and Ireland. Forty per cent were consultant dermatologists and Mohs surgeons, 27% were consultant dermatologists, 15% were registrars, 7% were Mohs fellows, and 11% were of other groups. The mode age range was 45–49 years (23%) followed closely by 40–44 years (22%). Forty-seven per cent were female and 51% were male. The mode number of hours operating per week was ∼4–8 h (28%; range from ∼4 h or less to ∼40 h or more). Seventy-six per cent operated standing, while 22% shifted between sitting and standing. Regarding pain directly related to undertaking surgery, 34% experienced neck pain ‘sometimes’, with 16% reporting pain ‘often’ and ‘always’. Forty-three per cent experienced lower back pain ‘sometimes’, with 11% reporting lower back pain ‘often’ and 22% reporting back pain ‘never’. Thirty-eight per cent reported stiffness related to undertaking surgery ‘often’ or ‘sometimes’, while 43% reported ‘never’ experiencing stiffness. Nineteen per cent wore loupes while operating, with 71% of this group reporting that loupes made their posture ‘much better or better’. Most respondents began to have symptoms after 5 years of operating. Over a third of respondents had physiotherapy for their pain. Forty-nine per cent of respondents felt more pain on days they operated. Seventy-eight per cent of respondents had no formal education on ergonomics at their institution. These results highlight that chronic pain is prevalent among dermatological surgeons in the UK and Ireland. Modification of footwear, table height, operating position, lighting and surgical instruments may all improve ergonomics. Surgeons should also be mindful of their posture, hold instruments lightly, take microbreaks, stretch during their surgical day and aim to maintain fitness outside of work. Ergonomics training should be incorporated formally into educational meeting updates, and consideration of formal guidelines from associated physician bodies should be prioritized in order to protect the health and wellbeing of dermatological surgeons and prevent musculoskeletal injury, early burnout and retirement.